• 한국컴퓨터정보학회논문지
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• 제4권2호
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• pp.80-87
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• 1999

우리는 공동연구 PACS 환경을 이용하는 여러 가지 영상의학 응용을 제의한다. 전통적인, 거의 모든 의학이미지는 방사선학의 필름을 인쇄하였다. 그들 필름을 생산하는데 비용이 많이 들고 잘못되기가 쉽고 복사 보존이 일반적이다. 따라서, 이미지에 대한 동시 접근하는데는 이용 인원이 제한된다. 그러나 PACS(영상기록 및 통신시스템)에 내포된 장점은 매우 많고 작은 저장소, 저렴한 유지비용, 매우 효과적이고, 개발비용은 높은 편이나 매우 유연성이 있다. 이 연구는 네트워크 환경에서 홈PC를 위한 영상의 학 시스템이 영상의학의 대부분이 CATV 브로드케스팅 기술로써 고비용의 단독 회선과 하드웨어를 사용하였다. 그러나 이 시스템은 사이버 공간에서 상호영향의 여러 가지 형식을 통해 의사와 환자간의 협력에 있어 보다 나은 이용을 위한 흠PC 변화에 대하여 기여 할 것이다.

• 한국의료질향상학회지
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• 제9권2호
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• pp.116-133
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• 2002

Background : It is very common in Korea to take care of non-acute patients in an acute setting, due to the lack of long-term facilities. Long term hospitalization increase medical expenses and decreases the bed utilization, which can affect the urgent and emergent admissions, and eventually jeopardize the hospital financially. In this study, strategies for effective transfers to the lower levels of care, and to decrease the length of stay were presented by surveying and analyzing the patient's knowledge of the transfer needs, and the willingness to transfer those whose hospital length of stay was more than 30days. Method : The survey is subject to a group of 251 patients who have been hospitalized over 30 days in a general hospital in Seoul. Excluding those that were in the Intensive Care Unit and psychiatric ward, 214 in-patients were used as participants. They were surveyed from April 9, 2002 to April 17, 2002. One hundred and thirty seven out of 214 were responded which made the response rate 64%. Data were analyzed by SAS and SPSS. Result : Multi-variable Logistic Regression Analysis showed a significant effect in medical expenses, knowledge of referral system and the information of the receiving hospital. The financial burden in medical expenses made the patient 10.7 times more willing to be transferred, knowledge of the referral system made them 5 times more willing to be transferred, and the information of receiving hospital makes 6.5 times more willing to be transferred. Reasons for willing to be transferred to a lower level of care were the phase of physical therapy, the distance from home, the attending physician's advice and being unable to be treated as an out patient. Reasons for refusing to be transferred were the following. The attending physician's competency, not being ready to be discharged, not trusting the receiving hospital's competency due to the lack of information, or never hearing about the referring system by the attending physician. Conclusion : Based on this, strategies for the effective transfer to the lower levels of care were suggested. It is desirable for the attending physician to be actively involved by making an effort to explain the transfer need, and referring to the Healthcare Coordinating Center, which can help the patient make the right decision. Nationwide networking for the referral system is the another key factor that may need to be suggested as an alternative to decrease the medical expenses. Collaborating with the Home Health Agency for the early discharge planning and the Social Service Department for financial aid are also needed. It is recommended that the hospital should expedite the transfer process by prioritizing the cost and the information as medical expenses, knowledge of referring system and the information of the receiving hospital, are the most important factors to the willingness to transfer to a lower level of care.

• 지역사회간호학회지
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• 제14권2호
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• pp.179-189
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• 2003

Objectives: This study described the features of home-bound industrial accident victims and their needs for rehabilitation services. This study was also aimed to find a future direction of development of community rehabilitation programs that are suitable for their needs demands. Methods: This study is a descriptive study, were collected through two phases using structured questionnaire. In the first stage, su were performed via telephone interviews. In the se stage, surveys were performed via home visit Subjects in the first stage included 2203 indu injured victims staying at home, of whom. individuals complaining of post-traumatic complic became the subjects of the second stage. Results: This study showed that the home-bound industrial accident patients were complaining of complications from the injury even after receiving treatment by IACI. However, they were neglecting their health problems without any intervention. Even if they use health care services. the treatment is mainly focused on acute medical care, which may not effective for them. Furthermore, they had unstable employment status and suffered from financial burden for health care costs. The Labor Welfare Organization has established a plan to remove barriers of industrial accident victims in reinstatement, and has been preparing various programs in order to establish an all-embracing service system for industrial accident victims from accident occurrence to reinstatement. However, these rehabilitation services can be truly helpful only when the injured are able to obtain enough information about them. The current restrictive system is also not appropriate for solving health problems of the industrial accident victims. Therefore, it is necessary to develop a plan that can provide industrial accident victims high-quality rehabilitation services so that they can use those services in the community without being dependent on hospitals. This study proposes visit nursing services as a way to provide various health services within community for the industrial accident victims.

• 한국콘텐츠학회논문지
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• 제13권7호
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• pp.203-213
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• 2013

본 연구는 65세 이상의 고령자를 대상으로 하는 '헬스케어기반의 고령친화적 스마트홈' 조성을 위해 현행 관련 법제도의 한계에 기인하여 국내외 법제도를 비교법적인 분석을 통해 개선방안을 살펴보고자 한다. 이를 위해 원격의료 시행을 전제로 관련 법제도는 '헬스케어'와 '고령친화' 그리고 '스마트홈 관련 법제도로 크게 3개 부문으로 나누어 고찰했다. 헬스케어 관련 법제도는 국내 의료법에 의해 원격의료를 시행하고 있지만, 의료진과의 정보교환(원격자문 역할)으로 제한을 두고 있다. 국외사례를 토대로 원격의료(모니터링)를 위한 개념 및 제반 사항에 대한 정의 등을 규정할 필요가 있으며, 고령친화 관련 법제도 분석 결과, 고령자에 대한 정의가 불분명하며 보건의료체계에 대한 정비가 필요하다. 이러한 분석 결과를 토대로 관련법제도 개선의 필요성을 인지하고 현행 관련 개별법에 대한 개정을 통한 법제도의 정비와 신규 법률 제정을 통한 개선방안을 제시하였다. 본 연구는 국내외 관련 법제도의 비교법적인 분석을 통한 개선방안을 제시하는 것이지만, 두 가지 대안은 각각의 장단점을 가지고 있어 어느 것이 최선의 선택이라고 결론을 내리기 어려운 것이 본 연구의 한계이다.

• 성인간호학회지
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• 제12권4호
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• pp.507-516
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• 2000

This study examines that North American Nursing Diagnosis Association(NANDA) and Home Health Care Classification(HHCC) is appropriate to classify home health care client's nursing problems and suggests a modified nursing diagnosis classification system. Two hundred and forty-nine clients' records at a general hospital were reviewed and nursing problems were diagnosed according to each classification system. Results of this study are as follows. The major client's medical diagnosis are pregnancy, childbirth and puerperium, malignant neoplasm, and benign neoplasm. Of four hundred and sixty-three nursing problems, all nursing problems made a diagnos according to HHCC, while three hundred and eighty-five made a diagnosis according to NANDA. The HHCC diagnosis included 78 more nursing problems than NANDA. The discrepancy in the results may indicate a significant advantage to HHCC diagnosis because HHCC nomenclature was created empirically from hard data. However, this may be due to limitations in the data collection method so determination of which classification system is more useful is difficult to judge. However, nursing components of the HHCC are more concrete and clearer than human response patterns of the NANDA. Also the HHCC facilitates the documentation of patient care by computer, while using a conceptual framework consisting of 20 Care Components based on the nursing process: assessment, diagnosis, outcome identification, planning, implementation and evaluation. Accordingly, the practical application of HHCC is more useful than NANDA. Limitations of this study include a retrospective data collecting method and universality of samples. Further research for various samples that use prospective data collection method is recommended.

• 대한의용생체공학회:의공학회지
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• 제25권2호
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• pp.129-135
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• 2004

재택건강관리 시스템은 주로 정상인들로부터 빈번하게 측정한 생체신호의 실시간 처리과정을 필요로 한다. 본 논문에서는 이러한 환경에서 측정되는 심전도 신호에서 DRS를 검출하기 위한 단순화된 알고리즘과 검출된 QRS의 정상과 비정상 여부만을 분류하는 알고리즘에 대하여 기술한다. 기존에 사용되고 있는 실시간 QRS 검출 알고리즘을 세분화하여 단순화된 QRS 검출 알고리즘을 제안함으로서 저가형 소형 단말기에서도 사용이 가능하도록 하였다. 또한 검출된 QRS들로부터 QRS 폭, R-R 간격, DRS 형태변수를 추출하여 QRS의 정상과 비정상을 판단하는 알고리즘을 개발하였다. 단순화된 QRS 검출기의 성능과 정상과 비정상의 분류성능은 각각 약 99%와 96%로 나타났다. 본 논문에서 제안된 QRS 검출과 분류를 위한 알고리즘들은 복잡한 신호처리 과정이 필요치 않으므로 재택건강관리 시스템에서의 실시간 심전도처리에 사용될 수 있을 것이다

• 대한간호학회지
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• 제24권4호
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• pp.696-705
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• 1994

This study was done to provide a basis for home health care management for women following Cesarean delivery. Furthermore it was initiated as an possible application of home health care in the future. In this study, client selection criteria was developed by the researcher and assessment tools for home health care, recording system and problem oriented recording system were revised from Jun's(1993) methods. The selection criteria tool for home health care for women who had a Cesarean delivery was structured and consisted of five areas : physical status, functional status, psychological-emetional status, educational needs status and environmental status. The structured assessment tool consisted of general items, obstetric history, past medical history, methods of feeding, medications taken before ad-mission, laboratory results, discharge instructions, discharge medications, family tree, economic status, environmental status, a map, health assessment of women and their newborns. The visit note consisted of the date : nursing problems : nursing process including initial assessment : nursing goals : visit plan : health status of the postpartum women and their newborn : nursing diagnoses : nursing implementation evaluation : summary : next visit plan and revision. The problem oriented recording system consisted of the date, problem numbers, nursing diagnoses, problem appearance date, problem resolution date. The results of the research are as follows : The seven cases having had a Cesarean delivery were discharged on an average on the 5th day after the Cesarean birth. The total number of home visits was 13. According to Cordon's functional health patterns the total possible nursing diagnoses was 34 diagnoses for the methers and their newborns. Among the 34 diagnoses, there were 13 diagnoses in the health perception /management pattern, 7 in the psychosocial health perception / management pattern, 8 in the psychosocial self-perception, 2 in the nutrition / metabolism pattern of physical function, 2 in the knowledge deficit of newborn management, anxiety related to newborn management, knowledge deficit related to disease process of new-born, anxiety related to disease process of newborn anxiety related to prognosis of baby's condition, knowledge deficit related to newborn jaundice each appeared once. The changes in the number of nursing diagnoses was related to not the number of visits but to the number of nursing diagnoses decreasing. The con-tent of the home health care was categorized ac-cording to assessment, direct care, counseling, education, family care. The recommendation based on the results of this research are Home health care nurses for Cesarean postpartum women and their neonates requires comprehensive knowledge of pregnancy, delivery, and the postpartum period and of the neonate so that they can provide appropriate care and holistic views. Most of cases terminated after the second visit, this outcome may be related to the subjects being discharged on the 5th day after delivery. Therefore, study done with earlier discharge after delivery may have different outcome. It is very hard to assess psychological aspects that need follow-up and to develop communication channels.

• 의료법학
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• 제13권1호
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• pp.41-69
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• 2012

First introduced in 1977, Korean health care system reached to national coverage in short period of time never seen before in any other countries, and rated as successful system protecting the health of the public at relatively low price. However, despite those positive evaluations, some of fraudulent medical organizations or pharmacies are hindering the sound development of the national health care system with meticulous false billing exaggerating the number of patients or the days of their treatment. To prevent aforementioned nursing home fraud and false billing, the misconduct should be punished as subject to the criminal law and severally punished for fines and payments which far exceed the expected amount of illicit gains as it is basically violation of criminal fraud, other than the forced return of illicit gains based on civil laws. Furthermore, the Health Insurance Review and Assessment Service should strengthen and complement the fraud investigators, the review process, and the professional training to raise the detection rates. It might also want to review ways to implement whistleblower rewarding system and rewards for evidences of healthcare fraud to overcome the limits of external review.

• 대한전자공학회:학술대회논문집
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• 대한전자공학회 2009년도 정보 및 제어 심포지움 논문집
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• pp.402-404
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• 2009

The development of health information technology enables people to access, view and acquire personal health record. But still, there have been a number of obstacles such as the absence of the standard to realize the ideal Personal Health Record(PHR) system. In this study, we proposed the service model that serves periodic Health Record Summary which is made by a medical specialist to people who are in the busy lives. Healthcare data from EMR in a hospital including people generate themselves at home is sent to a physician to make a medical opinion, and then it is changed into Health Level 7 Continuity of Care Document(CCD) format for interoperability. After a physician writes his opinion about patient's health condition, it will send to people by email. People who receive the health record summary data by email can save them into a USB device to view own PHR and medical comments of a physician through a computer. It will help people managing their own health condition with an opinion of a medical specialist.

• 한국전자통신학회논문지
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• 제7권6호
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• pp.1555-1560
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• 2012

최근 사람들의 평균 수명이 늘어남으로써 노령인구, 장애인, 주기적으로 자신의 건강상태를 확인하는 사람 등에게 원격 의료서비스를 제공하기 위한 건강관리에 관심이 고조되고 있다. 가정생활에서의 기초적인 건강상태 확인 및 의료 도우미 시스템은 고가의 의료장비를 이용하지 않고 저렴한 비용으로 확인이 가능해야 하며 간단한 방식으로 활용할 수 있어야 한다. 본 논문에서는 광센서를 이용하여 손가락 끝의 맥박신호 정보를 검출하고 맥박신호의 이상 유무나 맥박간격의 규칙성 정보를 분석할 수 있는 3G 네트워크 기반의 맥박측정 시스템을 개발하고 적합성을 검토하였다.